No Room At The Inn

 

November’s “tridemic” of RSV, influenza, and COVID-19 continued to overwhelm hospitals and medical clinics across the nation last week. In a letter sent to President Biden and HHS Secretary Becerra, the American Academy of Pediatrics and the Children’s Hospital Association urgently called on the government for help:

Dear President Biden and Secretary Becerra:

On behalf of America’s pediatricians and children’s hospitals, we ask you to declare an emergency to support the national response to the alarming surge of pediatric hospitalizations due to pediatric respiratory syncytial virus (RSV) and influenza along with the continuing children’s mental health emergency.

 

The request for government support comes at a time when providers and health systems are seeing “unprecedented levels of RSV happening with growing flu rates, ongoing high numbers of children in mental health crisis and serious workforce shortages […] combining to stretch pediatric care capacity at the hospital and community level to the breaking point.”

A rapid federal response to the crisis would address capacity issues in hospitals and allow more telehealth services while waiving certain insurance requirements that can block efficient patient care, says Ariel Cohen:

Coupled with an earlier-than-usual flu season and a cold-weather uptick in COVID-19 cases, the RSV outbreak has children’s hospitals on the brink. Pediatric hospitals are seeing the highest influenza hospitalization rate going back a decade, said Jose Romero, director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases. Across the United States, hospitals have run out of room as pediatricians pull long hours and face burnout, with many states reporting more than 90 percent of pediatric beds occupied.

 

Lisa O’Mary describes a health care system stretched to the limit:

At least six hospitals – three of them children’s hospitals – have set up overflow tents as influenza and respiratory syncytial virus (RSV) tally record-breaking case counts, Becker’s Hospital Review reported.

CDC-reported pediatric RSV rates ebbed slightly in the past week but remain remarkably high. Among children age 17 and under, nearly 12 in 100,000 were hospitalized across the country with RSV, according to the most recent week’s data. The rates for infants are startling: 145 in 100,000 babies 6 months or younger are being hospitalized.

On the pediatric influenza front, 6 children per 100,000 were hospitalized in the past week. Five children have died this flu season.

 

For the second year in a row, UPMC Children’s Hospital of Pittsburgh erected an outdoor tent to accommodate the overflow of seriously ill kids, reports Sarah Boden:

The hospital said in a video on Twitter that the tent adds up to 10 beds to the department. “This tent is well equipped and fully staffed, enabling us to further streamline our process as we assess the needs of our patients.”

Like last fall, the temporary addition comes due to longer ER wait times, which have recently exceeded eight hours.

 

Jessica L. Peck, DNP reviews pediatric infection control strategies that can help prevent the transmission of respiratory pathogens and lower the burden of illness on children, parents, pediatricians, and hospitals:

Handwashing

It is well documented that effective handwashing is by far the best way to prevent organism transmission. The CDC estimates that approximately 1.8 million child deaths occur each year from communicable disease, but advises that effective handwashing could protect as many as 1 in 3 children from diarrheal illnesses and 1 in 5 children from respiratory illnesses.

Families should wash their hands before, during, and after food preparation; before eating; when arriving back home after being in the community; after toileting; after caring for or playing with pets; and after playing outside. Children should be taught to cough into their elbow or a tissue and to wash their hands afterward.

Nutrition and Sleep

These general measures of health are evidence based regarding the prevention of infection complications. The role of sleep is important in immune regulation response. Children should get an adequate amount of sleep each night with a consistent bedtime routine. Every effort should be made to provide nutritious meals.

Antibiotic Stewardship

Each year in the United States, there are 2.8 million antibiotic-resistant infections with more than 35,000 deaths. The annual cost to treat multidrug-resistant infections is more than $4.6 billion. Antibiotic stewardship is vital in preventing the development of drug-resistant infections in children.

Vaccination

Providers should use every visit as an opportunity to ensure that every child has maximum protection from vaccine-preventable illness, rather than simply assessing that during well-child visits. In the face of increasing parental requests for alternative vaccine schedules, providers should follow the guidelines on routine immunization as published by the CDC and the Advisory Committee on Immunization Practices. This includes all routine childhood vaccinations, seasonal influenza vaccination, COVID-19 vaccination, and catch-up vaccinations.

 

Unfortunately, childhood vaccination coverage has declined significantly during the pandemic. We’ll take a look at that disturbing trend tomorrow on The PediaBlog.

Read “Infection Control in Pediatrics: Primary Preventions to Promote Child Health” here.

 

(Google Images/Pittsburgh Post-Gazette)

 

source http://www.thepediablog.com/2022/11/21/no-room-at-the-inn/